Group Accident & Health Coverage

Is there a gap in your group client’s coverage?

A recent case study, involving an analysis of a typical Canadian group client, indicated that significant gaps in coverage can exist which the employer may not be aware of. Even with a comprehensive benefits plan, including coverage for LTD, AD&D, and Out-Of-Country emergency medical, employees may be exposed to risks beyond the ability of the group plan to provide coverage.

Consider the following:

Question 1 – Most stand group AD&D and LTD policies have a War Risk Exclusion. Could this constitute a gap for employers?

Answer 1 – In our global economy, travel to volatile regions is often a regular occurrence for many employees. How would the policy respond if an employee happened to be injured during an insurrection while travelling on the employer’s behalf? What would be the employer’s responsibility/liability? This could certainly be considered a gap.

Question 2 – Does the standard Out-Of-Country Medical coverage included in most group plans address the needs of an employee travelling on company business?

Answer 2 – Non necessarily: not all policies afford the same level of coverage. Many reimburse only to the amount payable by the provincial healthcare system, which is unlikely to cover the full cost which can be incurred in another country. Also, many plans limit the number of travel days and most do not include security evacuation.

Question 3 - Several larger companies have a board of directors made up of both employees and non-employees. However, many group plans only cover regular full-time employees. Could this be an issue?

Answer 3 – Yes. Non-employees, such as members of a board of directors or contract employees often travel on the company’s behalf. Consideration should be given to the liability issue which could arise for an employer if one of these non-employees were injured while representing them.

If you are interested in a no obligation quote, please either contact us at 416-754-3910/1-800-773-8638 or email Chris Gory.

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